心脏磁共振心功能曲线对急性心肌梗死患者左心室舒张功能的评价  

Evaluation of left ventricular diastolic function in patients with acute myocardial infarction using cardiovascular magnetic resonance function curve

作　　者：姚若钤 胡玲静[2] 刘婉琪 李相妍 赵丽[1] 李爽[1] 孙峥[1] 刘志[4] 卢洁[1] YAO Ruoqian;HU Lingjing;LIU Wanqi;LI Xiangyan;ZHAO Li;LI Shuang;SUN Zheng;LIU Zhi;LU Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Yangjing Medical college,Capital Medical University,Beijing 101300,China;First School of Clinical Medicine,Capital Medical University,Beijing 100053,China;Department of Emergency,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]首都医科大学燕京医学院,北京101300 [3]首都医科大学第一临床医学院,北京100053 [4]首都医科大学宣武医院急诊科,北京100053

出　　处：《医学影像学杂志》2024年第12期43-47,共5页Journal of Medical Imaging

基　　金：国家自然科学基金资助项目(编号:62172288);首都医科大学“本科学生科研创新”项目(编号:XSKY2024396)。

摘　　要：目的探讨心脏磁共振心功能曲线的衍生参数评估急性心肌梗死患者的左心室舒张功能。方法选取首都医科大学宣武医院急性心肌梗死患者60例。以心脏彩色多普勒超声检查结果作为分组标准,分为舒张功能正常组(正常组)、舒张功能受损组(Ⅰ组)、舒张功能降低组(Ⅱ组)。基于对比增强平衡稳态自由进动电影序列的心功能曲线分析,定量评价舒张充盈衍生参数,以及对左心室扩张的诊断效能。结果Ⅱ组的舒张容积恢复时间(diastolic volume recovery,DVR)最长,为(492.2±54.8)ms,与正常组(429.8±100.8)ms和Ⅰ组的舒张容积恢复时间(473.0±66.7)ms比较,差异无统计学意义(P>0.05);Ⅱ组的归一化心室第一容积速率(normalized peak E,NE)为(3.0±0.7)s^(-1),第二容积速率(normalized peak A,NA)为(1.7±0.4)s^(-1);Ⅱ组的舒张峰值延迟时间最短,为(259.8±56.7)ms。舒张期左心室第二容积速率(A)对心室扩张的诊断效能最高,曲线下面积0.9,约登指数为0.82。结论心功能曲线分析可有效识别左心室舒张功能受损,以较高的一致性和诊断效能为急性心肌梗死患者的预后判断提供新思路。Objective To explore the derivative parameters of the cardiovascular magnetic resonance function curve and to evaluate the left ventricular diastolic function in patients with acute myocardial infarction(AMI).Methods Sixty patients with AMI in Xuanwu Hospital of Capital Medical University from June 2021 to October 2023 were collected retrospectively.Using echocardiography as grouping criteria,based on the analysis of the cardiac function curve of contrast enhanced-steady state free precession(CE-SSFP)sequence,the diastolic filling parameters,and diagnostic efficiency of left ventricular dilatation were quantitatively evaluated.Results The results showed that the diastolic volume recovery time(DVR)of Group Ⅱ was the longest(492.2±54.8)ms,but compared with the normal group(429.8±100.8)ms and Group Ⅰ(473.0±66.7)ms,the difference was not statistically significant(P>0.05);The normalized peak E(NE)of Group Ⅱ was(3.0±0.7)s^(-1),and the normalized peak A(NA)was(1.7±0.4)s^(-1);the delay time of diastolic peak in Group Ⅱ was the shortest,at(259.8±56.7)ms.The second diastolic left ventricular volume rate(A)was the most effective in diagnosing ventricular dilation,with an area under the curve of 0.9 and a Jordan index of 0.82.Conclusion This study confirms that cardiac function curve analysis can effectively identify left ventricular diastolic function impairment,and provide a new way of judging the prognosis of acute myocardial infarction patients with high consistency and diagnostic efficiency.

关 键 词：心功能曲线 急性心肌梗死 舒张功能 磁共振成像 

分 类 号：R542.22[医药卫生—心血管疾病] R445.2[医药卫生—内科学]